Whether or not the creators of UNSANE were aware that that title was used for the butchered U.S. release of Dario Argento’s TENEBRAE, their movie doesn’t take overt stylistic cues from thrillers of the past (the very ’70s final shot aside). One of the key story points, in fact, is very much tied to the here and now.

That’s not just the themes of stalking, or a woman struggling to make herself heard in the face of male doubt and indifference—which, while absolutely topical nowadays, certainly aren’t new to the screen. Rather, it’s the reasons why Sawyer Valentini (Claire Foy), a young businesswoman trying to get over traumatic events in her recent history, winds up an unwilling patient at the Highland Creek Behavioral Center. Those won’t be revealed in detail here, but they resonate with key concerns of the modern day. While director Steven Soderbergh and writers Jonathan Bernstein and James Greer aren’t making a political polemic, some of the forces victimizing Sawyer carry an identifiability for many viewers beyond those who’ve had to deal with harassment.

As UNSANE opens, that’s the distress Sawyer is trying to put behind her. The specifics aren’t revealed till later, but we learn enough to know that a man’s obsession with her has compelled her to move from Boston to Pennsylvania, and has left her with intense relationship issues. She tries for a no-strings-attached hookup, only to emotionally break down before she can consummate it. Seeking therapy for her brittle psyche, she goes to Highland Creek for what seems like a simple introductory interview, but which leads her to essentially become a prisoner. The matter-of-factness with which she’s committed (voluntarily, she’s told, since she signed some papers at which she didn’t take a close enough look) is part of what’s scary about the situation—even before she meets an orderly (Joshua Leonard) who dispenses her meds and calls himself George Shaw, but whom she’s convinced is David Strine, who fixated on her in Boston and has now apparently followed her to the hospital.

Is it really David, or is Sawyer’s mind playing tricks on her? And if it is David, how did he either effect her commitment to Highland Falls, or just happen to be there when she came for her unexpectedly extended visit? The former is part of the tension Soderbergh and the writers build through UNSANE’s first half, and the latter is a plausibility worm that gets a bit in the way of the suspense. It’s worth noting here that UNSANE is not quite the shock machine the ads are promising; it’s more of a psychodrama that’s less about terrifying the audience and more about getting them to share Sawyer’s distress and frustration.

In that, it succeeds thanks to Foy, whose wholehearted performance puts across the film’s central gambit: Sawyer behaves (as many of us no doubt would in this situation) in an aggressive, confrontational way that doesn’t help her cause, yet that doesn’t excuse the staff, male and female, for not taking her seriously. UNSANE is a canny combination of old-fashioned snake-pit melodrama and he-said/she-said relatability, with the much-publicized shooting on the iPhone giving the visuals an unpolished you-are-there immediacy. Foy receives colorful support from the varied turns by her co-stars: Leonard, good and creepy in the is-he-or-isn’t-he? role, and initially unrecognizable with his added heft and heavy beard; Juno Temple, also unidentifiable at first in dyed-black cornrows, throwing herself into the part of Sawyer’s wacko-est wardmate; and comedian Jay Pharoah, effectively playing it straight as a more sympathetic patient. It’s also nice to see veteran actress Amy Irving as Sawyer’s mom, facing her own vexation trying to free her daughter.

After the controlled anxiety of its first hour, UNSANE eventually ventures into the more horrific areas promised by those ads, which deliver viscerally even as they inevitably lose the intriguing ambiguity of what has come before. In the end, even with the 21st-century sociopolitical overtones, Soderbergh and co. don’t really break much new ground here, but the solid acting and craftsmanship on all levels succeed in keeping your mind on their work.

Michael Gingold (RUE MORGUE's Head Writer) has been covering the world of horror cinema for over three decades, and spent 28 years as a writer and editor for FANGORIA magazine and its website. In addition to RUE MORGUE, he currently writes for BIRTH.MOVIES.DEATH, SCREAM, IndieWire.com, TIME OUT, DELIRIUM and others. His book THE FRIGHTFEST GUIDE TO MONSTER MOVIES (FAB Press) is out this fall, and he has contributed liner notes and featurettes to a number of Blu-ray and DVD releases. Among his screenplay credits are SHADOW: DEAD RIOT and LEECHES!, and he is currently working on THE DOLL with director Dante Tomaselli.